For many people struggling with obesity and obesity-related conditions, the time has come to consider bariatric weight-loss surgery, which makes changes to the digestive system.
Bariatric surgery can be especially helpful for people who are obese but have not been able to lose weight through diet, exercise and medications.
“Bariatric procedures are usually considered only when other efforts to lose excess weight, have failed,” says William Fuller, MD, a bariatric surgeon at Scripps Clinic. “Generally, the patient has severe obesity and obesity-related conditions, such as type 2 diabetes and heart disease, or is at risk of these conditions.”
Surgery can also help improve high blood pressure, unhealthy cholesterol levels, sleep apnea, joint and other body pain and urinary incontinence.
Studies show that people with type 2 diabetes experience rapid improvement in their blood sugar levels after weight-loss surgery.
For some patients, combining weight loss medications and bariatric surgery produces the best possible results.
Bariatric surgery works by reducing the physical size of the stomach, limiting the amount of food it can hold and curbing appetite. Bariatric means “related to treatment for heavy weight.”
Most bariatric surgeries are done using minimally invasive techniques where a few small incisions are made instead of a long incision. This usually results in shorter hospital stays, fewer complications, shorter recovery and better cosmetic results.
“Your surgeon will recommend the proper weight-loss surgery based upon your medical condition, prior operations, weight history and other factors,” Dr. Fuller says.
Scripps also offers nonsurgical weight-loss services for patients who don’t qualify for surgery.
Having a body mass index (BMI) above 30 is considered obese. But this alone doesn’t make one a candidate for surgery.
Surgery is usually considered only after diet, exercise and medication have failed to do the job. “Even then, careful selection is critical for successful outcomes,” Dr. Fuller says.
To be a candidate for the procedure, a patient must:
- Have a BMI of 35 or higher
- Have a BMI between 30 and 34.9 and a serious obesity-related health problem (such as type 2 diabetes, coronary heart disease or severe sleep apnea)
- Undergo medical, psychological and nutritional evaluations to make sure they are ready for surgery and can make the required lifestyle changes
Like any surgery, bariatric surgery has risks, including:
- Leaking from site of operation
- Blood clots
Follow-up interventions for surgery-related problems are not uncommon. Problems rarely lead to death, according to the National institute of Health.
Patients struggling with severe obesity and/or obesity-related conditions should understand that the risks of remaining in their condition are far greater than the risks of bariatric surgery.
Bariatric surgery is not a quick fix and requires a lot of work and commitment.
Patients can lose a significant amount of weight but can also regain a portion if they don't commit to lifestyle changes. That is why the most successful patients are motivated, stay well-informed and are able to participate in long-term care follow-up.